HomeMy WebLinkAboutPresubmission Materials GENERAL SITE NOTES
NO PHYSICAL POSSESION r3
LAND NOW OR FORMERLY OF
'LONE:R-80 RESfill:\CL
DAMES H. JACOBS JR, do SHARON M. JACOBS \\ \
S.SINGL 1000-113-12-102 BULK ZONING TABLE 1. UNSUITABLE MATERIAL,CONSTRUCTION DEBRIS,EXCESS SOILS,ETC.SHALL BE PROPERLY REMOVED AND DISPOSED OF '
ZONE:x-so RESIDENCE SINGLE FAMILY RESIDENCE OFF-SITE IN ACCORDANCE WITH ALL APPLICABLE CODES,ORDINANCES,AND LAWS.
LAND NOW OR FORMERLY OF ZONING DISTRICT:LB LIMITED BUSINESS t_;\1
THOMAS R. TALBOT r•,t�`
S.C.T.T 1000 R.
TALB 2-10.3 2. THE CONTRACTOR IS RESPONSIBLE TO TAKE EROSION CONTROL MEASURES NECESSARY IN ACCORDANCE WITH NYS 4'
00.00 ITEM SECTION PERMITTEDIREQUIRED PROPOSED
SINGLE FAMILY RESIDENCE N 87 16'40"E STANDARDS AND SPECIFICATIONS FOR EROSION&SEDIMENT CONTROL TO PREVENT SEDIMENT AND/OR LOOSE DEBRIS .
280 FROM WASHING ONTO ADJACENT ROADWAYS AND PROPERTIES.
\ MINIMUM LOT AREA ATTACH 80,000 SF 111,848 SF(2.57 ACRES)
\ MENT4 3. ALL ON-SITE CONCRETE SHALL BE IN CONFORMANCE WITH ACI PROVISIONS. ALL CURBING SHALL BE CONCRETE UNLESS
280
OTHERWISE NOTED.
® ` MINIMUM LOT WIDTH ATTACH 175' 300'
4. RELOCATION AND/OR REMOVAL OF EXISTING UTILITY POLES, TRAFFIC SIGNS, ETC., SHALL BE COORDINATED BY THE
® MENT4
EXIST.WOODED - CONTRACTOR. THE CONTRACTOR IS RESPONSIBLE FOR FIELD-VERIFYING THEIR PRESENCE, ¢ `�$
rn p BUFFER AREA T0� rn v 280
U L
m REMAIN ~ ? MINIMUM LOT DEPTH ATTACH 200' 400.03' 5. WORK WITHIN THE R.O.W.OF MIDDLE COUNTRY ROAD SHALL BE PERFORMED IN ACCORDANCE WITH ALL APPLICABLE
MENT4 REQUIREMENTS OF SUFFOLK COUNTY REGULATIONS.
y y y .,, y y y y y y y y "'G" �_'ry -iy�-�ti .,,/�r �-W` �h +�y-.'-'�`✓ "` Y,'."' Y
y y y Y 48
R20' \ 6. ALL TRAFFIC CONTROL DEVICES, I.E. SIGNALS, SIGNS, AND PAVEMENT MARKINGS SHALL BE INSTALLED IN rik¢�4"d
y y y MAXIMUM FRONT YARD 280-43 A 100' 100, CONFORMANCE WITH THE GUIDELINES OF THE NEW YORK STATE MANUAL OF UNIFORM TRAFFIC CONTROL DEVICES AND
PROP.EDGE OF �l-- `
y y y y y
y y y y y R3' PAVEMENT(TYP.) R3G' y y y ®K� AS DIRECTED BY THE TOWN OF SOUTHHOLD.DIVISION OF TRAFFIC SAFETY. ALL PAVEMENT MARKINGS REQUIRED SHALL
w y y y y y PROP.10'X 10' PROP. ASPHALT-"""I"' 280 BE THERMOPLASTIC NYSDOT SPECIFICATIONS)UNLESS OTHERWISE NOTED ON PLAN.
y y y y -RASH ENCLOSURE -I► --►
y y y y PAVEMENT � MINIMUM SIDE YARD ATTACH 20' 54'
y y �7Q ON CONC.PAD R10' R5, R8' R5' 2 �G MENT4 7. CONTRACTOR SHALL SAWCUT TO THE FULL DEPTH OF EXISTING PAVEMENT WITH A STRAIGHT VERTICAL EDGE FREE
y y / R15' y y y � `"A FROM IRREGULARITIES WHEREVER NEW PAVEMENT JOINS EXISTING PAVEMENT. CONTRACTOR SHALL DETERMINE
/ PROP.10'X 10' y y y y y R3' y y 'o y 0A \ 280
�,� -y EXACT LOCATION AND EXTENT OF THE REQUIRED SAWCUTTING IN ORDER TO PERFORM THE WORKSCOPE DEPICTED ON
TRASH ENCLOSURE y y y y y v o \ MINIMUM REAR YARD ATTACH 75' 75' THE PLANS. TWO FT MINIMUM FROM CURBS, PADS, WALKS, AND WALLS TO PERMIT PROPER COMPACTION OF THE
y y REPLACED SURFACES.
y y 25.I' y y y y • y J r�l Y y v�A Q MENT4
.v ON CONC.PAD '1 n � y �,
y R18' y y Q y y A R3 1 v o
®y y y U� �u y y 280 r+R p LANDSCAPE AREA ATTACH 35% 42.9°!°(47,961 SF) 8. REMOVAL INCLUDES, BUT IS NOT LIMITED TO, CURBING, PAVEMENT, UNSUITABLE MATERIALS, AND UNDERGROUND
y y y MENT4 PIPING. QUESTIONABLE ITEMS ENCOUNTERED(ABOVE AND/OR BELOW GRADE)SHALL BE BROUGHT TO THE ATTENTION +�.' ` °•. Ma data*2024 Terms Re ort a ma error
y y y y R2' �� ', 280 OF THE OWNER AND ENGINEER OF RECORD IMMEDIATELY IN WRITING BEFORE REMOVAL OR DISTURBANCE. P
MAXIMUM
y y y s y \ COVERAGE ATTACH 20°'° 19.7%(22,006 SF) 9, THE CONTRACTOR SHALL EXERCISE EXTREME CARE WHEN PERFORMING ANY WORK ACTIVITIES ADJACENT TO EXISTING VICINITY IVIP
\ MENT 4 FOUNDATIONS AND OTHER STRUCTURES TO REMAIN. CONTRACTOR SHALL BE RESPONSIBLE FOR TAKING THE
y y � r ✓"� 280 APPROPRIATE MEASURES AS NECESSARY TO ENSURE THE STRUCTURAL STABILITY OF EXPOSED AND/OR BELOW GRADE N.T.S.
MAXIMUM BUILDING
ATTACH 35721/2 STORIES 18'(1 STORY) FOUNDATIONS!WALLS/SIDEWALKS AND PAVEMENT TO REMAIN,AND SHALL PROVIDE A SAFE WORK AREA. ANY DAMAGE
y y • "" NPN��P��I�PI 6g� ` PROP. ADA&'VAN HEIGHT MENT4 OR DISTURBANCE DUE TO SUBJECT WORKSCOPE SHALL BE REPAIRED TO LIKE-KIND CONDITIONS AT THE PROJECT DATA
�G. y ACCESSIBLE'SIGNS(TYP.OF 2) A PROJECT SHALL BE DIVIDED INTO SEPARATE CONTRACTOR'S EXPENSE.
TAX MAP NUMBER..................... Dist.1000.Sect.113,Block 12.Lot 13
�� RES SO THAT NO SINGLE STRUCTURE
STRUCTURES
�: y Y y � N y 256 PROP.'NO PARKING SHALL HAVE MORE THAN 60 LINEAR FEET OF 10. THE CONTRACTOR SHALL TAKE APPROPRIATE MEASURES TO PROTECT PEDESTRIANS AND VEHICULAR TRAFFIC DURING SITE AREA.................................. 111,848 SF(2.57 Acres)
"> ANYTIME'SIGN \ REMOVAL ACTIVITIES. ANY TZAFFIC CONTROL, ACCESS, AND SAFETY PROVISIONS WITHIN THE R.O.W. AND ACCESS
4 y `P FRONTAGE ON ONE STREET.THE SETBACKS OF
19 MIN.STRUCTURE ROUTES E.G.ACCESSIBLE RAMPS, PEDESTRIAN CROSSWALKS,SIDEWALKS,PAVEMENT STRIPING,ETC.)SHALL BE THE ZONING....................................... LB LIMITED BUSINESS
y y 41 FRONTAGE 280-50-C MULTIPLE STRUCTURES ON A PARCEL MAY VARY, COMPLIES CONTRACTOR'S RESPONSIBILITY. THE CONTRACTOR SHALL DETERMINE APPROPRIATENESS OF REMOVAL ACTIVITIES
® /"" J •✓' 25 ` r^ PROVIDED THAT THE AVERAGE SETBACK OF THE CURRENT USE........................... VACANT
y J AND PROVIDE TEMPORARY MEASURES FOR THE PROTECTION AND SAFETY OF THE PUBLIC UNTIL PERMANENT
STRUCTURES MEETS THE SETBACK� ABOVE AND ALL BUILDINGS ARE AT LEAT5 REQUIRED COMPONENTS/REPLACEMENTS CAN BE INSTALLED. PROPOSED USE......................... CONTRACTOR'S BUSINESS
y W NG`N FEET FROM THE RIGHT-OF-WAY. PROPOSED FOOTPRINT........... 22,006 SF
y O��dSA, PROPOSED 1-STORY o� rn y y 11, IF SHORING AT A DEPTH GREATER THAN 5' IS REQUIRED TO ACCOMMODATE CONSTRUCTION ACTIVITIES, IT SHALL BE
y I -0 � ' W y y y y y IN ALL NONRESIDENTIAL DISTRICTS,THERE THE CONTRACTOR'S RESPONSIBILITY TO RETAIN A LICENSED PROFESSIONAL ENGINEER TO DESIGN THE REQUIRED LANDSCAPE/NATURAL AREA... 47,961 SF
ca BUILDING y
W y RT � - CONTRACTOR'S R3' y o y y y y fix' \ SHALL BE A LANDSCAPED STRIP IN THE FRONT SHEETING AND SHORING DETAILS.SHEETING SHALL BE IN CONFORMANCE WITH OSHA REQUIREMENTS.
a rn w rn PAVEMENT/CONCRETE AREA... 41,881 SF
BUSINESS :' `Y y •' y y y y �, \ MIN.LANDSCAPE YARD AREA;THE STRIP SHALL BE 25'.THERE
280-93-8 COMPLIES
s 11.003 SF BUFFER SHALL BE ALSO BE A LANDSCAPED AREA 5'WIDE 12. THE CONTRACTOR SHALL BE RESPONSIBLE FOR VERIFYING THE EXACT LOCATION,SIZE,TYPE,AND DEPTH OF UTILITIES,
R3, y 10 y y y y y y ��'` ABUTTING THE FRONT OF THE BUILDING IN ALL PIPING, DRYWELLS, ETC. PRIOR TO THE START OF ANY WORK. THE CONTRACTOR MUST CONTACT THE APPROPRIATE
\\ PROP.EDGE OF ®y y y y 4 NON RESIDENTIAL DISTRICTS. LOCAL"ONE CALL"SYSTEM TO ENSURE THAT ALL UTILITIES ARE PROPERLY AND COMPLETELY MARKED OUT IN THE FIELD
PAVEMENT(TYP.) y � 1000* y y y W '-� PRIOR TO ANY WORK AT THE SITE. ANY DISCREPANCIES BETWEEN THE FIELD LOCATIONS AND THE PLANS SHALL BE
Y y A BUFFER AREA SHALL BE REQUIRED ALONG ALL
REPORTED TO THE ENGINEER IN WRITING IMMEDIATELY. THE CONTRACTOR IS ADVISED THAT UTILITY INFORMATION
y .r PROPOSED 1-STOP,Y ref y y y y BOUNDARIES OF A NONRESIDENTIAL LOT SHOWN ON THE PLAN IS A COMPILATION OF FIELD LOCATIONS.ABOVEGROUND STRUCTURES THAT WERE VISIBLE AND
TRANSITION BUFFER 280-94- ABUTTING ANY LOT IN A RESIDENTIAL DISTRICT.
PROP.'NO PARKING 9 :� BUILDING y y y 45' ACCESSIBLE IN THE FIELD,AND RECORD DRAWINGS AVAILABLE AT THE TIME OF THE SURVEY AND MUST BE CONFIRMED
r^ \ AREA B(3) SUCH BUFFER AREA SHALL COMPLY WITH AT
ANYTIME'SIGN y CONTRACTOR'S o y y -cs MINIMUMACCORDINGLY. THE CONTRACTOR SHALL COORDINATE UTILITY DISCONNECTION WITH THE APPLICABLE UTILITY
y BUSINESS ?a ;u =' y y y d \ LEAST THE FOLLOWING CT:20STANDARDS: COMPANIES PRIOR TO REMOVAL ACTIVITIES, THE CONTRACTOR IS ALSO ADVISED THAT ALL SUCH FACILITIES
\ PROP. ADA&'VAN " LIMITED BUSINESS DISTRICT:20 FEET
®y � 11,003 SF ��, �- �' y ® 7< DISTURBED DURING CONSTRUCTION MUST BE REPAIRED OR REPLACED AT THE CONTRACTOR'S EXPENSE.
\ ACCESSIBLE'SIGNS oa W ,/" y y
ANY DISTRICT OTHER THAN A RESIDENTIAL 13. THE CONTRACTOR SHALL COMPLETELY FILL BELOW GRADE AREAS AND VOIDS RESULTING FROM THE REMOVAL OF
�, ,�*''" y y TRANSITION BUFFER 280.94- DISTRICT ADJOINING LAND OWNED OR 25 6' STRUCTURES AND FOUNDATIONS WITH SOIL CONSISTING OF MATERIALS FREE FROM DEBRIS, TRASH, FROZEN
AREA B(6) MAINTAINED BY NEW YORK STATE,SUFFOLK MATERIALS,ROOTS AND OTHER ORGANIC MATTER. STONES USED SHALL NOT BE LARGER THAN 6 INCHES IN DIMENSION.
14 y V y PROP.EDGE OF \ COUNTY OR SOUTHOLD TOWN WITH CURRENT PRIOR TO PLACEMENT OF FILL MATERIALS,UNDERTAKE ALL NECESSARY ACTIONS IN ORDER TO ENSURE THAT AREAS TO
y y PAVEMENT(TYP.) OR POTENTIAL USE AS PARKLAND:25 FEET. BE FILLED ARE FREE OF STANDING WATER,FROST,FROZEN MATERIAL,TRASH AND DEBRIS. PLACE FILL MATERIALS IN
NO PHYSICAL POSSESIpN y \ HORIZONTAL LAYERS NOT EXCEEDING 6 INCHES IN LOOSE DEPTH AND COMPACT EACH LAYER AT PLACEMENT TO 95%
LAND NOW OR FORMERLY OF ROP.CONCRETE ?, y y , OPTIMUM DENSITY. GRADE THE SURFACE TO MEET ADJACENT CONTOURS AND TO PROVIDE SURFACE DRAINAGE.
\ GULLY REALY, Ll-C � J
ZONE:PI2o1EC'I't D REFER TO GEOTECHNICAL REPORT(IF PROVIDED)FOR FURTHER RECOMMENDATIONS. REFER TO GRADING PLAN FOR
\ s.c.r.M. V000113-1a-1z �y ��F,. SIDEWALK ROP. CONCRETE y PARKING CALCULATIONS PROPOSED SURFACE ELEVATIONS.
y y tsaifj ri.° .y �?, �ssk�t:. p y SIDEWALK y
R3' R20' R5, ITEM SECTION PERMITTED/REQUIRED PROPOSED 14. UNDERGROUND STORAGE TANKS, IF ENCOUNTERED, SHALL BE EMPTIED, CLEANED AND REMOVED FROM THE SITE IN
y y y y y ) ..;.•• y y y y �• y ACCORDANCE WITH FEDERAL;STATE,COUNTY,AND LOCAL REQUIREMENTS.
LONE:LB LIMI FED BUSINESS y y y y y y y y y y w S.C.T.M. 1000-113-12-14 \y y y "•y _ 'y y W y y y y : •y y y y y y y •Y `' LAND NOW OR FORMERLY OF MINIMUM STALL SIZE 280-78-C 9'x 19' 9'X19'
y y "VyOv�Y y y y y y y y ROP. CONC.CURB y y y V y y y y y y y y TOWN OF SpvrHOLD \ 15. PROPOSED TREE PROTECTION FENCE TO BE INSTALLED BEFORE THE START OF REMOVAL ACTIVITIES AND TO BE
y y W y y y y y y y (TYP) y y W W W W R33' y y y ® VACANT REMOVED AFTER CONSTRUCTION IS COMPLETE.REFER TO LANDSCAPE PLAN FOR DETAILS.
\ y y y y ^•, y y y y y y y R15 R15 y y y y y y y y
\ y •y y y �,c7 R20' _....___......_�..- y y y y '� MINIMUM AISLE WIDTH 280-78-C 22'MIN.WITH 90°PARKING 25'WITH 90°PARKING
t o
y � m / � R15' y y y y y y 16. THE CONTRACTOR SHALL BE RESPONSIBLE FOR COMPLYING WITH THE SPECIFICATIONS OF THE LOCAL AUTHORITIES
-/ REGARDING MATERIALS AND INSTALLATION OF PROPOSED WORK,FOR OBTAINING THE REQUIRED PERMITS,SIGN OFFS.
y <- PROP ASPHALT Q- ,a y y y Y y y I C
s y y y y y T N 1 U FOR COLLECTOR ROADS&15'FOR
PAVEMENT -n ..>, AND CONSTRUCTION INSPECTIONS,ACCORDING TO GOVERNING BUILDING CODES AND DISPOSAL OF ALL MATERIAL IN
y R45' ` y y y y y y z ACCESS DRIVEWAY SECONDARY HIGHWAYS(ONE WAY) ACCORDANCE WITH STATE ANf LOCAL LAW,
PROP. STOP SIGN WIDTH
20'FOR COLLECTOR ROADS&30'FOR 30'TWO-WAY
(TYP. R40' SECONDARY HIGHWAYS TWO WAY c,
} \ ( ) 17. SIDEWALKS,CURBS,OR OTHF EXISTING SITE APPURTENANCES DAMAGED BY CONSTRUCTION SHALL BE REPAIRED OR
y y y y y W PROP.CONC.CURB Y y y y y y y y y y Z �p p c REPLACED IN KIND OR UNLES<'NOTED OTHERWISE UNO WHETHER SPECIFIED ON THIS PLAN OR NOT,AT THE SOLE
r^ R \ ® W W W R25 (TYP.) Y W y ® MINIMUM PARKING ( )
`} \' m 280-78-J-2 10'FROM ALL PROPERTY LINES COMPLIES COST Of THE CONTRACTOR.
SETBACK
®® W y y y W y R25,
PROP.CONC.CURB y y ` y y m y y y y y y y y y y ^y y y y 18, THE ENGINEER OF RECORD IS NOT RESPONSIBLE FOR CONSTRUCTION MEANS AND METHODS. NO. DATE BY DESCRIPTION
(TYP.) y y y W W y y y y W y y y y y y y W y FOR MANUFACTURING,WHOLESALE AND
STORAGE USES AND FOR DRY-CLEANING AND 19. SEQUENCE AND COORDINATION OF CONSTRUCTION IS SOLELY THE CONTRACTOR'S RESPONSIBILITY. �+
y y y y L y y y y y y y y y y y y y y y \ RUG-CLEANING ESTABLISHMENTS AND REVISIONS
PROPOSED----,. y y W y y y y y
\ O y y W y w y LAUNDRIES:ONE BERTH FOR 5,000 TO 10,000 20. PRIOR TO THE COMh1ENCEMENT OF ANY WORK WITHIN A SUFFOLK COUNTY RIGHT-OF-INAY THE
\ EXIST.WOODED `O 30' LANDSCAPE AREA y y y y y y y y y NUMBER OF LOADING SQUARE FEET OF FLOOR AREA IN SUCH USE, APPLICANT/OWNER/DEVELOPERICONTRACTOR MUST OBTAIN A RIGHT-OF-WAY WORK PERMIT FROM THE SCDPW.
y y y y y J y y _ _ _ ® 280-79-A-6 NOT APPLICABLE
\ BUFFER AREA TO (y a SPACES REQUIRED AND ONE ADDITIONAL BERTH FOR EACH
y W y L y y y y y y y y y y y y y y y y y y y
\ REMAIN « ADDITIONAL 10,000 SQUARE FEET OF FLOOR 21. ANY UTILITIES T INCLUDING P LES REQUIRED TO BE RELOCATED DUE TO THE INSTALLATION OF THE REQUIRED
y y y •Y ('
�® 5'WIDE FILL EASEMENT IN AREA OR FRACTION THEREOF SO USED.IN IMPROVEMENTS SHALL BE RELOCATED AT THE EXPENSE OF THE APPLICANT]OWNER/DEVELOPER/CONTRACTOR.
FAVOR OF COUNTY OF SUFFOLK ADDITION,ADEQUATE RESERVED PARKING FOR A �
V WAITING TRUCKS SHALL BE PROVIDED. 22. ALL TRAFFIC ROAD MARKINGS ROAD SIGNS,AND LIGHT SIGNALS THAT MAY HAVE BEEN MOVED OR DAMAGED IN THE "
525.64' PROCESS OF CONSTRUCTION SHALL BE RESTORED AT THE APPLICANT'S EXPENSE TO AT LEAST THE SAME QUALITY AND Ig
R35' R35' S S7"i 6'40" R' 300.00' MINIMUCHARACTERISTICS THAT EXISTED BEFORE CONSTRUCTION) BEGAN. THE APPLICANT SHALL BE FURTHER RESPONSIBLE r
EDGE OF PAVEMENT SPACE S1 LOADING 280.79-B 15'IN WIDTH,45'IN LENGTH,AND 14'CLEARANCE NOT APPLICABLE TO INSURE THAT, IN THE ROAD' -
C� SPACE SIZE ROADWAYS ADJACENT TO THE CONSTRUCTION SITE,THESE MARKINGS,SIGNS AND SIGNALS,
ARE MAINTAINED DURING THE ENTIRE PERIOD OF CONSTRUCTION.IF REPLACEMENT OR UPGRADE IS REQUIRED,SAh4E /i,/ c•.. �;;
PRdp.'STOP'&'NO �S• / / MUST BE APPROVED BY THE SC'vVPW. /d
/ LEFT TURN SIGN
MINIMUM NUMBER OF 23. ALL ACCESSIBLE PARKING, CURB RAMPS.AND OTHER APPURTENANCES OF ACCESSIBLE ROUTES ARE TO MEET THE 564 BLUE POINT ROAD, UNIT B
/ -L- - STALLS 280 78 6 SF/1 SPACE PER 500 SF=44 STALLS 5 STALLS REQUIREMENTS OF THE 2020 N S BUILDING CODE CHAPTER 11 ACCESSBBLL AND ICC/ANSI Al7.1 2017.
CONTRACTOR BUSINESS 4 ,� ,TY A H®�„T6vILLE, RIE�I YORK 11742
_-...L_. 22,00
SOLID WHIiE LINE vviF-s24. IT IS THE RESPONSIBILITY Of THE CONTRACTOR TO REVIEW ALL OF THE DRAWINGS AND SPECIFICATIONS ASSOCIATED
'T �C3LJTTD VEX. WITH THE PROJECT WORKSCOPE PRIOR TO THE INITIATION OF CONSTRUCTION. SHOULD THE CONTRACTOR FIND A www.KeyCivilEngineering.com
- - ---- ....- - MIN.FRONT FACING 28-48-B-17-5-a NO GREATER THAN 30/°OF TOTAL NUMBER OF NO FRONT FACING RESPONSIBILITY TO NOTIFY TH=PROJECT ENGINEER IN WRITING PRIOR TO THE START OF CONSTRUCTION. FAILURE BY
EDGE OF PAVEMENT OFF-STREET PARKING PARKING STALLS PARKING PROVIDED PROJECT NAME
THE CONTRACTOR TO NOTIFY THE PROJECT ENGINEER SHALL CONSTITUTE ACCEPTANCE OF FULL RESPONSIBILITY BY
----GRASS MEDIAN DUE' R®e�D [v] VARIANCE REQUIRED THE CONTRACTOR TO COMPLETE THE SCOPE OF WORK AS DEFINED BY THE DRAWINGS AND IN FULL COMPLIANCE WITH
ra o�z �20�
LOCAL REGULATIONS AND COD[.
<SLT�'F�L.K C4 124 48) 25. THE CONTRACTOR SHALL COMPLY TO THE FULLEST EXTENT WITH THE LATEST O.S.H.A.STANDARDS AND REGULATIONS, �"�
OR ANY OTHER AGENCY HAVING JURISDICTION FOR EXCAVATION AND TRENCHING PROCEDURES. THE CONTRACTOR IS CONTMAV►
RESPONSIBLE FOR DETERMINING THE "MEANS AND METHODS" REQUIRED TO MEET THE INTENT AND PERFORMANCE
CRITERIA OF O.S.H.A.,AS WELL AS ANY OTHER ENTITY THAT HAS JURISDICTION FOR EXCAVATION AND/OR TRENCHING
PROCEDURES.
705 COUNTY ROAD 48
26. THE TOPS OF EXISTING MANHOLES, INLET STRUCTURES, AND SANITARY CLEAN-OUT TOPS SHALL BE ADJUSTED, IF MATTITUCK, NY 11952
REQUIRED.TO MATCH PROPOSED GRADES IN ACCORDANCE WITH ALL APPLICABLE STANDARDS.
LEGEND TOWN OF SOUTHOLD, COUNTY OF SUFFOLK
27. IN CASE OF DISCREPANCIES BETWEEN PLANS AND FIELD CONDITIONS,IMMEDIATELY NOTIFY THE PROJECT ENGINEER IN DIST.:1000, SECT.: 113, BLOCK: 12, LOT: 13
EXISTING ITEM PROPOSED
WRITING OF ANY CONFLICTS.
28. CONTRACTOR SHALL BE REQUIRED TO SECURE ALL NECESSARY PERMITS AND APPROVALS FOR ALL OFF-SITE MATERIAL DRAWING TITLE
®� PROPERTY LINE I
SOURCES AND DISPOSAL FACILITIES.CONTRACTOR SHALL SUPPLY A COPY OF APPROVALS TO PROJECT ENGINEER AND
BUILDING OWNER PRIOR TO INITIATING NORK.
29. CONTRACTOR SHALL DOCUMENT,WITH PHOTOS,CRITICAL STAGES OF CONSTRUCTION AND PROVIDE TO ENGINEER OF SITE LA DOOR LOCATION E
ENrExr RECORD AT END OF CONSTRUCTION.
OVERHEAD DOOR A 30. THE CONTRACTOR SHALL PER=ORM THE WORK AS SHOWN ON THE PLANS AND SPECIFIED HEREIN.THE PLANS SHOW
LOCATION OH THE GENERAL SCOPE OF THE WORK AND DO NOT NECESSARILY SHOW ALL DETAILS REQUIRED FOR COMPLETE FINISHED DATE: 11/15/2024
WORKING SYSTEMS, THE CONTRACTOR SHALL BE RESPONSIBLE FOR FURNISHING ALL MATERIALS AND LABOR AS
CONCRETE CURB NECESSARY FOR THE CONSTRUCTION OF COMPLETE WORKING SYSTEMS.
SCALE: 1"= 30'
SIGN 31. ELECTRICAL WORK SHALL BE IN CONFORMANCE WITH THE NATIONAL ELECTRICAL CODE(NEC).
PROJECT NUMBER: 24216
PAVEMENT MARKING ,� 32, ALL EXCAVATIONS SHALL BE BACKFILLED AT THE END OF EACH WORK DAY OR PROTECTED WITH TEMPORARY FENCING
ARROW) IN COMPLIANCE WITH OSHA REQUIREMENTS, DRAWING BY: JR
33. DEWATERING(IF REQUIRED)SHALL BE PERFORMED IN ACCORDANCE WITH LOCAL&STATE REGULATIONS,AND IT IS THE CHECKED BY: DP
ACCESSIBLE MARKING RESPONSIBILITY OF THE CONTRACTOR TO OBTAIN ANY NECESSARY ASSOCIATED DISCHARGE PERMITS.
PARKING SPACE
COUNT 10 34, SIGNS TO BE FILED UNDER SEPARATE APPLICATIONS BY OTHERS. r\����y APPROVED BY: MP
CONCRETEPAD �� SEAL& SIGNATURE: ALTERATION C PT BY ON TO THIS
CENSE
DOCUMENT EXCEPT BY A LICENSED
JAN31 2025 PROFESSIONAL ENGINEER IS A
LANDSCAPE AREA y y y -- VIOLATION OF SECTION 7209,
_...-- ` ��i E-)�f SUB-DIVISION 2,OF THE NEW YORK
$(A TROLD TOWN - 1 0 STATE EDUCATION LAW
��;i_b, NING S0ARD F'ILC
WOODED BUFFER LINE
DRAWING No:
GRAPHIC SCALE � Ii
i °G N T�/AL1DUNtlt�4$FALE IU
30 0 15 30 60 120 W r U
\\
( IN FEET )
Know what's b@IOW.
1 inch = 30 ft. Call before you dig. Ll
=
1-800-272-4480 MARC PILOTTA, P.E. PAGE No:
NEW YORK STATE PROFESSIONAL ENGINEER #081558 1 OF 1
Y:1Key CiVAPro,ects\2024\24216_Ron Kuoppa1a_705 County Road 48..Mattituck\DrawingslKey CivIH24216-.2024.11.15_SPP-O.dwg
�S�u�
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
SOUTHOLD,N.Y.
NOTICE OF DISAPPROVAL
DATE: February 14, 2025
TO: Ronald Kuoppala (Ulster Farms LLC/705 Main RdLLC) F30
63 Village Line Road -1=4�M, 13 C M
Babylon,NY 11702 R-1
Please take notice that your application dated November 18, 2024: FEB 14 2025
SOUTHOLD TOWN
For permit to: construct(?-) buildin&,s 1"or co.ntractor businesses at: KAMM BOARD
For
Location of property: 705 CR4
. ..._A1_Mlc attitL k NY
County Tax Map No. 1000- Section 113 Block .12 Lot 13
Is returned herewith and disapproved on the following grounds:
Pursuant to Article XXIJ ?28Q- 21., he )roposed use requires Site p lan a n I
j Section .L? _Eqyq_
from the Southold Town Planning fl3 ard.
p__
Additionally, the org�,sed�constEki %At,gxce ition appLoval p I alit
Article IX, Section 2_80.-4_1 B C2A.
You may now apply to these agencies directly.
iArutli-offiz&d Signature
Note to Applicant: Any change or deviation to the above referenced application,
may require further review by the Southold Town Building Department.
CC: file, Planning Board
'.
°^ 12'WIDE OA DOOR " I2'WIDE CA DOOR 12'WIDE OH.DOOR 12'WIDE ON.DOOR �
OFFICE OFFICE OFFICE OFFICE OFFICE
H.C.BATHToo
HL.BATH HL.BATH HL.BATH HL.BATH
0
TENANT 01 TENANT 2 TENANT 3 TENANT•4 TENANT 5
2]02DO OF 2;02D0 BF 2,202DO OF 2,202DO BF 2;20200 BF
--,TYPICAL 2 HOUR RATED UALL
12'WIDE OJ-L DOOR I2'WIDE OH_DOOR 12'WIDE OJ-L DOOR 12,WIDE OJ-L DOOR
low
�L OOi� i=L ,41�1 Buildings l&2 USE WILL BE UNDER SPECIAL E)(El`P 1014 B(2)CONTRACTORS®USINESS
------------------
-------- ...... .......
NUM. REVISION DATE AND NAME
REVISED:02-242025ITmmmmmmmm-
BUILDING NOTE
1. ( ■ RONALD KUOPPALA
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63 Villuga Lma Rand Nbylln,NY11702
T11516-797-8317 F.516511 6M89
NEW PREFAB STEEL BUILDING
F 705 C9wtY Road 48 W.m...rr Met0luck,NY
9
U
� FLOOR PLAN
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JAN 3 ', ?075 z ..-
°a D111: 10 NOVEMBER 2024
5uulnvLO fUWN 5�...ASNOTED
PLANNING BOARD 'DnwiagNa
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7'
JAN 3 1 2025
sOUMOLD TOWN
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F�'�e UeSo ®ra
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(jo(;t"rIGnuition
copy of Building permit Aj'�)pfic�l wn and s
"Should j)L, ,,;Ljj)n,jj(tcd.)
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TOWN OF SOUTHOLD—BUILDING DEPARTMENT
Town Hall Annex 54375 Main Road P. O. Box 1179 Southold,NY 11971 0959
Telephone (631) 765-1802 Fax (631) 765-9502
Date Received
APPLICATION FOR BUILDING PERMIT L Ia
For Office Use Only � � N 'i" N 8 r)021, �
PERMIT NO. Building Inspector: w _.�....................
Applications and forms must be filled out in their entirety. Incomplete
applications will not be accepted. Where the Applicant is not the owner,an
Owner's Authorization form(Page 2)shall be completed.
Date:11-18-2024
OWNER(S)OF PROPERTY:
Name:705 Main Rd LLC --T—SCTM#1000- 113-12-13
Project Address:705 County Road 48 Mattituck
Phone#:631-445-4348 Email:paulmpawlowski@gmail.com
Mailing Address:PO Box 1086, Westhampton Beach, NY 11978
CONTACT PERSON:
Name:Ronald Kuoppala Architect
Mailing Address:63 Village Line Road, Babylon NY 11702
Phone#:516-848-0932 Email:rka@rkarchitecture.com
DESIGN PROFESSIONAL INFORMATION:
Name:Ronald Kuoppala Architect PLLC
Mailing Address:63 Village Line Road, Babylon NY 11702
Phone#:516-848-0932 Email:rka@rkarchitecture.com
CONTRACTOR INFORMATION:
Name:
Mailing Address:
Phone#. Email:
DESCRIPTION OF PROPOSED CONSTRUCTION
®New Structure ❑Addition ❑Alteration ❑Repair ❑Demolition — _ Estimated Cost of Project
[--]Other _. $500,000.00
Will the lot be re-graded? *Yes []No Will excess fill be removed from premises? FlYes ONO
1
PROPERTY INFORMATION
Existing use of property:Vacant Intended use of propertY:2 - new pre-fab steel buildings
Zone or use district in which premises is situated: Are there any covenants and restrictions with respect to
LB - United Business this property? Eyes L*No IF YES, PROVIDE A COPY.
❑ Check Box After Reading: The owner/contractor/design professional is responsible for all drainage and storm water issues as provided by
Chapter 236 of the Town Code. APPLICATION 15 HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone
Ordinance of the Town of Southold,Suffolk,County,New York and other applicable Laws,Ordinances or Regulations,for the construction of buildings,
additions,alterations or for removal or demolition as herein described.The applicant agrees to comply with all applicable laws,ordinances,building code,
housing code and regulations and to admit authorized inspectors on premises and in building(s)for necessary inspections.False statements made herein are
punishable as a Class A misdemeanor pursuant to Section 210.45 of the New York State Penal Law.
Application Submitted By(print na Ronald Kuoppala RAuthorized Agent ❑Owner
Signature of Applicant: , Date: 11-18-2024
STATE OF NEW YORK)
6S:
COUNTY OF )
Ronald Kuoppala being duly sworn, deposes and says that(s)he is the applicant
(Name of individual signing contract) above named,
(S)he is the Agent
(Contractor,Agent, Corporate Officer,etc.)
of said owner or owners, and is duly authorized to perform or have performed the said work and to make and file this
application;that all statements contained in this application are true to the best of his/her knowledge and belief;and
that the work will be performed in the manner set forth in the application file therewith.
Swo.ti before me this
�day of 20
N
PATRICIA A STEEN
Notary Public-State of New York
N0.01ST6390190
PROPERTY OWNER AUTHORIZATIONQualified in Suffolk County
My Commission Expires Apr 8,2027
(Where the applicant is not the owner)
Paul Pawloski residing at 100 Park Ave, Mattituck, NY 11952
,
�do hereby authorize Ronald Kuoppala to apply on
my behalf to the Town of Southold Building Department for approval as described herein.
11 -18-2024
Owner's Signature Date
Paul Pawloski
Print Owner's Name
2
ZONING BOARD OF APPEALS M(�KMDWCSDD
TOWN OF SOUTHOLD,NEW YORK
Phone(631) 765-1809 FEB 19 2025
APPLICATION FOR GENERAL SPECIAL EXCEPTION SOUTHOLD TOWN
PLANNING BOARD
Applicant(s)/Owner(s): Paul Pawloski
Parcel Location: House No. 705 Street County Road 48 Hamlet: Mattitucic
Contact phone numbers: 631-445-4348 Email: paulmpawlowski@gmail.com
SCTM No. 1000 Section 113 Block 12_Lot(s) 13 Lot Size 2.57 acres Zone District LB
hereby apply to THE ZONING BOARD OF APPEALS for a SPECIAL EXCEPTION in accordance with
the ZONING ORDINANCE,ARTICLE IX , SECTION 280-41, SUBSECTION B (2)
Please indicate Special Exception criteria/requirements are met,if any:
for the following uses and purposes: Contractors Business
As shown on the attached survey/site plan drawn to scale. Site Plan review [ x ] IS or [ ] IS NOT required. Name
of Agent/Representative: Ronald Kuoppala Architect for(X)Owner( )Other:
Address: 63 Village Line Road, Babylon NY 11702
Telephone: 516-848-0932 Email: rlca@rkarchitecture.com
A. Statement of Ownership and Interest:
705 Main Road LLC is(are)the owner(s)of property known and referred
to as 704 County Road 48, Mattitucic NY
(House No., Street, Hamlet)
identified on the Suffolk County Tax Maps as District 1000, Section 113_, Block 12 , Lot 13 , and
shown on the attached deed. The above-described property was acquired by the owner on November 20,2024.
B. The applicant alleges that the approval of this exception would be in harmony with the intent and purpose of said zoning
ordinance and that the proposed use conforms to the standards prescribed therefore in said ordinance and would not be detrimental
to property or persons in the neighborhood for the following reasons:
No impact on surrounding property or to the Town of Southold
C. The property which is subject of this application is zoned LB and [ ] is consistent with the use(s)described
in the Certificate of Occupancy (attach copy), or [X] is not consistent with the Certificate of Occupancy being furnished herewith
for the following reason(s):
Property is Vacant
Please indicate(check)whether premises is vacant land: [ X ]
Zoning Board of Appeals-Page 2-Application—Special Exception-General
General Standards please answer the following as it pertains to your project:
A. The use willnot prevent the orderly and reasonable use of adjacent properties or of properties in adjacent use districts
BECAUSE:
The project is consistent with existing neighboring properties
B. The use will not prevent the orderly and reasonable use of permitted or legally established uses in the district wherein
the requested use is located or of permitted or legally established uses in adjacent use districts BECAUSE:
The project is consistent with existing neighboring properties
C. The safety,the health, the welfare, the comfort,the convenience or the order of the town will not be adversely affected
by the proposed use and its location BECAUSE:
The project meets all bulk zoning requirements
D. The use will be in harmony with and promote the general purposes and intent of Chapter 280-142 BECAUSE
The project is consistent with existing neighboring properties
E. The use will be compatible with its surroundings and with the character of the neighborhood and of the community in
general,particularly with regard to visibility, scale and overall appearance BECAUSE:
The building are setback far enough away from the street and are properly landscaped from the neighboring properties
F. All proposed structures, equipment, and material shall be readily accessible for fire and police protection BECAUSE:
The new buildings are made of steel and there is a road around the property for easy access to these buildings
G. The proposal shall comply with the requirements of Chapter 236,Stone-water Management BECAUSE:
All the storm water will be stored on the property with drywells
By signing this document, the PROPERTY OWNER understands that pursuant to Section 280-141D [including
280-1411)(1),D(2),D(3)] of the Code of the Town of Southold,a violation of any limitation or condition of a
special exception approval or of any provision of this chapter applicable to a special exception use shall constitute
a violation of this chapter. The Zoning Board of Appeals shall retain jurisdiction and shall have the right,after a
public hearing,to modify,suspend or revolve such approval or any term or condition thereof or to impose
thereon one or more new conditions,all on the grounds listed in Chapter 280-141D [including 280-1411)(1),D(2),
D(3)] of the Code of the Town of Southold. FURTHERMORE,IT IS THE PROPERTY OWNER'S
RESPONSIBILITY TO ENSURE COMPLIANCE WITH THE TOWN CODE REQUIRED TIME FRAME.
SEE CHAPTER 280-141C. -21
Signature of Applicant or Authorized Agent
(Agent must submit written Authorization from
Owner)
COUNTY OF SUFFOLK) Ronald Kuoppala
ss.. PRINT NAME
STATE OF NEW YORK)
Sworn to before me this day 10
of ,20=2S
i
(Notary Public
Zoning Board of Appeals
APPLICANT'S PROJECT DESCRIPTION
Please complete sections below that apply
APPLICANT: Paul Pawloski SCTM No. 1000-113-12-13
1.For Demolition of Existing Building Areas
Please describe areas being removed: Vacant
II.New Construction Areas (New Dwelling or New Additions/Extensions):
Dimensions of first floor extension: (2)New Steel buildings @ 11,0002.6sf each- Total =22,005.20sf
Dimensions of new second floor:
Dimensions of floor above second level:
Height(from existing natural grade): 18'-0"
Is basement or lowest floor area being constructed?If yes, please provide height(above ground)measured from
natural existing grade to first floor:
III.Proposed Construction Description(Alterations or Structural Changes)
(Attach extra sheet if necessary). Please describe building areas:
Number of Floors and General Characteristics BEFORE Alterations: Vacant Lot
Number of Floors and Changes WITH Alterations: (1)
IV. Calculations of building areas and lot coverage,GFA,sky plane(From Surveyor,Design Professional):
Existing square footage of buildings on your property:None
Proposed increase of building coverage: 19.67% Square
footage of your lot:111,848.00 SF Percentage of
coverage of your lot by building area(lot coverage) Gross Floor Area
GFA of a residential dwelling on a residential lot, including the attached garage and/or habitable detached accessory
structure: (Please refer to Chapter 280, Section 280-207 of the Town Code):
For Residential dwellings on Residential lots, is project within the allowable Sky Plane?(Please refer to Chapter 280,
Section 280-208 of the Town Code):
V. Purpose of New Construction: (10)-New tenant space's for Contractor's Businesse's
VI.Please describe the land contours (flat,slope %, heavily wooded,marsh area,etc.) on your land and how it
relates to the difficulty in meeting the code requirement(s): Describe on separate page if needed:
Gentle slope and wooded vacant lot
Please submit 8 sets of photos,labeled to show different angles of yard areas after staking corners for new
construction, and photos of building area to be altered with yard view.
Revised:03/2024
QUESTIONNAIRE SPECIAL EXCEPTION
FOR FILING WITH YOUR ZBA APPLICATION
a) Has a determination been made regarding Site Plan review? Yes_X_No
If no, please inquiry with the ZBA office. If site plan is required,you may apply to the Planning Dept. at the
same time so both applications can be reviewed concurrently.
b) Are there any proposals to change or alter land contours?
a. No _X_Yes, please explain on attached sheet.
c) Are there areas that contain sand or wetland grasses?No
d) Are those areas shown on the survey submitted with this application?No
e) Is the property bulk headed between the wetlands area and the upland building area?No
f) If your property contains wetlands or pond areas,have you contacted the Office of the Town Board of Trustees
for its determination of jurisdiction?No
Please confirm status of your inquiry or application with the Trustees:N/A and if issued,
please attach copies of permit with conditions and approved survey.
g) Is there a depression or sloping elevation near the area of proposed construction at or below five feet above mean
sea level?N/A
h) Are there any patios,concrete barriers,bulkheads or fences that exist that are not shown on the survey that you
are subm itting?N/A Please show area of the structures on a diagram if any exist or state none on the above
line.
i) Do you have any construction taking place at this time concerning your premises?No If yes,please submit a
copy of your building permit and survey as approved by the Building Department and please describe:
j) Please attach all pre-certificates of occupancy and certificates of occupancy for the subject premises. If any are
lacking, please apply to the Building Department to obtain copies of them.
k) Do you or any co-owner also own other land adjoining or close to this parcel?No_. If yes,please label the
proximity of your lands on your survey.
1) Please list present use or operations conducted at this parcel(—Vacant Lot
and the proposed use Proposed(2)- new pre-fab steel buildings
(ex: existing single family, proposed: same with garage,pool
or other or vacant proposed office with apartments above,etc.)
1
Authorised signature and Date
Ronald Kuoppala Architect
Print Name and Title(Owner,Representative)
APPLICANT/OWNER
TRANSACTIONAL DISCLOSURE FORM
The Town of Southold's Code of Ethics prohibits conflicts of interest on the part of town officers and employees The purpose of this form is to
provide information which can alert the town of possible conflicts of interest and allow it to take whatever action is necessary to avoid same
YOUR NAME: Kuoppala, Ronald
(Last name,first name,middle initial,unless you are applying in the name of someone else or other entity,such as a company.
If so,indicate the other person's or company's name.)
TYPE OF APPLICATION: (Check all that apply)
Tax grievance Building Permit
Variance X Trustee Permit
Change of Zone Coastal Erosion
Approval of Plat Mooring
Other(activity) Planning
Do you personally(or through your company,spouse,sibling,parent,or child)have a relationship with any officer or employee of
the Town of Southold?"Relationship" includes by blood,marriage,or business interest."Business interest" means a business,
including a partnership, in which the town officer or employee has even a partial ownership of(or employment by)a corporation
in which the town officer or employee owns more than 5%of the shares.
YES NO X
If you answered"YES",complete the balance of this form and date and sign where indicated.
Name of person employed by the Town of Southold
Title or position of that person
Describe the relationship between yourself(the applicant/agent/representative)and the town officer or employee.Either check the
appropriate line A)through D)and/or describe in the space provided.
The town officer or employee or his or her spouse,sibling,parent,or child is(check all that apply)
A)the owner of greater that 5% of the shares of the corporate stock of the applicant(when the applicant is a
corporation)
B)the legal or beneficial owner of any interest in a non-corporate entity(when the applicant is not a corporation)
C)an officer,director,partner,or employee of the applicant;or
D)the actual applicant
DESCRIPTION OF RELATIONSHIP
Submitted this 14- day of 20 Z
-__4w
Signature o
Print Name: Ronald Kuoppala Architect
Board of Zoning Appeals Application
AUTHORIZATION
(Where the Applicant is not the Owner)
1, Paul Pawloski residing at 100 Park Ave, Mattituck, NY 11952
(Print property owner's name) (Mailing Address)
do hereby authorize Ronald Kuoppala Architect
(Agent)
to apply for variance(s) on my behalf from the
Southold Zoning Board of Appeals.
(Owner's S1 nature KATHLEEN CAGGIANO
Notary Publlo,State of Now York
No.01 CA62392.90
Quelilied in Sultolk County
Paul Pawloski Commission Expires April 18,2 6 X 7
(Print Owner's Name)
AGRICULTURAL DATA STATEMENT
ZONING BOARD OF APPEALS
TOWN OF SOUTHOLD
WHEN TO USE THIS FORM: This form must be completed by the applicant for any special use permit,site plan approval,use
variance,area variance or subdivision approval on property ivillun an agricultural district OR within 500 feet of a farm
operation located in an agricultural district. All applications requiring an agricultural data statement must be referred to the
Suffolk County Department of planning in accordance with Section 239m and 239n of the General Municipal Law.
1. Name of Applicant: Roanld Kuoppala Architect
2. Address of Applicant: 63 Village Line Road,Babylon,NY 11702
3. Name of Land Owner(if other than Applicant):705 Main Road LLC
4. Address of Land Owner: PO Box 1086, Westhampton Beach,NY 11978
5. Description of Proposed Project:(2)-new Pre-Fab Steel buildings with(10)-tenant spaces
6. Location of Property: (Road and Tax map number): 705 CR 48,Mattituck-SCTM-1000-113-12-13
7. Is the parcel within 500 feet of a farm operation? { } Yes { X}No
8. Is this parcel actively farmed? { } Yes { X) No
9. Name and addresses of any owner(s)of land within the agricultural district containing active farm operations. Suffolk County
Tax Lot numbers will be provided to you by the Zoning Board Staff. It is the Applicant's responsibility to obtain the current
names and mailing addresses from the Town Assessor's Office(765-1937)
NAME and ADDRESS
I.
2.
3.
4.
5. - -
6.
7.
(Pler use the back of this page if there are additional property owners)
/ l Gam / � Z�Z �
Signature of Applicant Date
Note:
1.The local Board will solicit comments from the owners of land identified above in order to consider the effect of the
proposed action on their farm operation. Solicitations will be made by supplying a copy of this statement.
2. Comments returned to the local Board will be taken into consideration as part as the overall review of this
application.
3.Copies of the completed Agricultural Data Statement shall be sent by applicant to the property owners identified
above. The cost for mailing shall be paid by the Applicant.
Full Environmental Assessment Form
Part 1 -Project and Setting
Instructions for Completing Part 1
Part'] is to be completed by the applicant or project sponsor. Responses become part of the application for approval or funding,
are subject to public review,and may be subject to further verification.
Complete Part I based on information currently available. 11'additional research or investigation would be needed to fully respond to
any item, please answer as thoroughly as possible based on current information.indicate whether missing information does not exist,
or is not reasonably available to the sponsor;and,when possible,generally describe work or studies which would be necessary to
update or fully develop that information.
Applicants/sponsors must complete all items in Sections A&B. In Sections C,D&E,most items contain an initial question that
must be answered either"Yes"or"No". If the answer to the initial question is"Yes",complete the sub-questions that follow. if the
answer to the initial question is"No",proceed to the next question. Section F allows the project sponsor to identify and attach any
additional information. Section G requires the name and signature of the applicant or project sponsor to verify that the information
contained in Part 1 is accurate and complete.
A.Project and Applicant/Sponsor Information.
Name of Action or Project:
Proposed Contractor's Business Buildings
Project Location(describe, and attach a general location map):
705 County Road 48,Mattituck,NY 11952,Town of Southhold,County of Suffolk
Brief Description of Proposed Action(include purpose or need):
Proposed construction of(2)1-story building contractor's business.Proposed site improvements including grading,drainage,sanitary,lighting and
landscape.
Name of Applicant/Sponsor: Telephone:516-848-0932
Ronald Kuoppala Architect E-Mail:
RKA@rkarchitecture
Address:63 Village Line Road
City/PO:Babylon State:NY Zip Code:11702
Project Contact(if not same as sponsor;give name and title/role): Telephone:
E-Mail:
Address:
City/PO: State: Zip Code:
Property Owner (if not same as sponsor): Telephone: 516-848-0932
705 Main Road LLC E-Mail: RKA@rkarchitecture
Address:
PO Box 1086
City/PO: Westhampton State: NY Zip Code:11978
Page 1 of 13
B.Government Approvals
B. Government Approvals, Funding,or Sponsorship. ("Funding'includes grants,loans,tax relief,and any other forms of financial
assistance.)
-Government Entity If Yes: Identify Agency and Approval(s) Application Date
Required (Actual or projected)
a. City Counsel, Town Board, ❑YesmNo
or Village Board of Trustees
b. City,Town or Village mYes❑No Planning Board
Planning Board or Commission
c. City,Town or R[Yes❑❑No Town of Southold Zoning Board Of appeals
Village Zoning Board of Appeals
d.Other local agencies mYes❑No Suffolk County water Authority
e. County agencies mYes❑No Suffolk county Department of Health Services &
Suffolk County DPW
f. Regional agencies ❑YesmNo
g. State agencies mYes❑No NYSDEC SWPPP Permit
h. Federal agencies ❑YesmNo
i. Coastal Resources.
i. Is the project site within a Coastal Area,or the waterfront area of a Designated Inland Waterway? mYes❑No
ii. Is the project site located in a community with an approved Local Waterfront Revitalization Program? m Yes❑No
iii. Is the project site within a Coastal Erosion Huard Area? ❑YesmNo
C. Planning and Zoning
C.I. Planning and zoning actions.
Will administrative or legislative adoption,or amendment of plan, local law,ordinance,rule or regulation be the ❑YesmNo
only approval(s)which must be granted to enable the proposed action to proceed?
• If Yes, complete sections C,F and G.
• if No,proceed to question C.2 and complete all remaining sections and questions in Part 1
C.2.Adopted land use plans.
a. Do any municipally-adopted (city,town,village or county)comprehensive land use plan(s)include the site ❑Yes®No
where the proposed action would be located?
If Yes,does the comprehensive plan include specific recommendations for the site where the proposed action ❑Yes❑No
would be located?
b. Is the site of the proposed action within any local or regional special planning district(for example: Greenway; mYes❑No
Brownfield Opportunity Area(BOA);designated State or Federal heritage area;watershed management plan;
or other?)
If Yes,identify the plan(s):
NYS Heritage Areas:Ll North Shore Heritage Area
c. Is the proposed action located wholly or partially within an area listed in an adopted municipal open space plan, ❑YesmNo
or an adopted municipal farmland protection plan?
If Yes, identify the plan(s):
Page 2 of 13
C.3. Zoning
a. Is the site of the proposed action located in a municipality with an adopted zoning law or ordinance. ®Yes❑No
If Yes,what is the zoning classification(s)including any applicable overlay district?
LB Limited Business
b. Is the use permitted or allowed by a special or conditional use pennit? ®Yes❑No
c. Is a zoning change requested as part of the proposed action? ❑Yes®No
If Yes,
i. What is the proposed new zoning for the site?
CA. Existing community services.
a. In what school district is the project site located? Mattituck-Cutchoque UFSD
b. What police or other public protection forces serve the project site?
Southhold Town
c.Which fire protection and emergency medical services serve the project site?
Mattituck FD
d. What parks serve the project site?
Mill Roa—d_Pre erye—�aurel.Lake,Preserve&Park ---
D. Project Details
D.I. Proposed and Potential Development
a. What is the general nature of the proposed action(e.g.,residential,industrial,commercial, recreational; if mixed,include all
components)? Commercial
b. a.Total acreage of the site of the proposed action? 2.57 acres
b.Total acreage to be physically disturbed? 1.92 acres
c.Total acreage(project site and any contiguous properties)owned
or controlled by the applicant or project sponsor? 2.57 acres
c. Is the proposed action an expansion of an existing project or use? ❑Yes®No
i. If Yes,what is the approximate percentage of the proposed expansion and identify the units(e.g.,acres,miles,housing units,
square feet)? % _ Units:
d. is the proposed action a subdivision,or does it include a subdivision? ❑Yes®No
If Yes,
i. Purpose or type of subdivision?(e.g.,residential,industrial,commercial; if mixed,specify types)
ii. Is a cluster/conservation layout proposed? ❑Yes ONO
iii. Number of lots proposed?
iv. Minimum and maximum proposed lot sizes? Minimum Maximum
e. Will the proposed action be constructed in multiple phases? ❑Yes®No
i_ I rNo,anticipated period of construction: 10 months
ii. If Yes:
• Total number of phases anticipated
• Anticipated commencement date of phase I (including demolition) month year
• Anticipated completion date of final phase month year
• Generally describe connections or relationships among phases,including any contingencies where progress orone phase may
determine timing or duration of future phases:
Page 3 of 13
f.Does the,project include new residential uses? ❑Yes®No
If Yes,show numbers of units proposed.
One Family Two Family Three Family Multiple Family four or more
Initial Phase
At completion
of all phases
g.Does the proposed action include new non-residential construction(including expansions)? ®Yes❑No
If Yes,
i.Total number of strictures 2
ii. Dimensions(in feet)of largest proposed structure: 18' lieight; 58'width; and 189.7'length
iii. Approximate extent of building space to be heated or cooled: 22,006 square feet
h. Does the proposed action include construction or other activities that will result in the impoundment of any ❑Yes®No
liquids,such as creation of a water supply,reservoir,pond,lake,waste lagoon or other storage?
If Yes,
L Purpose of the impoundment:
ii. If a water impoundment,the principal source of the water: ❑Ground water❑Surface water streams ❑Other specify:
iii. if other than water, identify the type of impounded/contained liquids and their source.
iv. Approximate size of the proposed impoundment. Volume: _ million gallons; surface area: acres
v. Dimensions of the proposed dam or impounding structure: height; length
vi. Construction method/materials for the proposed dam or impounding structure(e.g.,earth fill,rock,wood,concrete):
D.2. Project Operations
a. Does the proposed action include any excavation, mining,or dredging,during construction,operations,or both? ❑YesZNo
(Not including general site preparation,grading or installation of utilities or foundations where all excavated
materials will remain onsite)
If Yes:
i.What is the purpose of the excavation or dredging?
ii. How much material(including rock,earth, sediments,etc.)is proposed to be removed from the site?
• Volume(specify tons or cubic yards):
• Over what duration of time?
iii. Describe nature and characteristics of materials to be excavated or dredged,and plans to use,manage or dispose of them.
iv. Will there be onsite dewatering or processing of excavated materials? ❑Yes❑No
If yes,describe. __ --- - -
v. What is the total area to be dredged or excavated? _ _ acres
vi. What is the maximum area to be worked at any one time? __ _ _ acres
vii. What would be the maximum depth of excavation or dredging? _ feet
viii. Will the excavation require blasting? ❑Yes❑No
it. Summarize site reclamation goals and plan:
b. Would the proposed action cause or result in alteration of, increase or decrease in size of,or encroachment ❑Yesg]No
into any existing wetland,waterbody, shoreline,beach or adjacent area?
I F Yes:
i. Identify the wetland or waterbody which would be affected(by name,water index number,wetland map number or geographic
description):
Page 4 of 13
ii. Describe how the proposed action would affect that waterbody or wetland,e.g.excavation,fill,placement of structures,or
alteration of channels,banks and shorelines. indicate extent of activities,alterations and additions in square feet or acres:
iii. Will the proposed action cause or result in disturbance to bottom sediments? ❑Yes[]No
If Yes,describe:
iv. Will the proposed action cause or result in the destruction or removal of aquatic vegetation? ❑Yes[r✓No
If Yes:
• acres of aquatic vegetation proposed to be removed:
• expected acreage of aquatic vegetation remaining after project completion:
• purpose of proposed removal(e.g.beach clearing,invasive species control,boat access):
• proposed method of plant removal:
• if chemical/herbicide treatment will be used,specify product(s): _ — --
v. Describe any proposed reclamation/mitigation following disturbance: --_
C. Will the proposed action use,or create a new demand for water? mYes❑No
If Yes:
i. Total anticipated water usage/demand per day: RRn gallons/day
ii. Will the proposed action obtain water from an existing public water supply? mYes❑No
if Yes:
• Name of district or service area: Suffolk county water district -_-
• Does the existing public water supply have capacity to serve the proposal? m Yes[]No
• is the project site in the existing district? mYes❑No
• Is expansion of the district needed? ❑Yes[Z]No
• Do existing lines serve the project.site?
mYes❑No
W. Will line extension within an existing district be necessary to supply the project? ❑YesmNo
if Yes:
• Describe extensions or capacity expansions proposed to serve this project:
• Source(s)of supply for the district:
iv. Is a new water supply district or service area proposed to be formed to serve the project site? ❑ YesmNo
if,Yes:
• Applicant/sponsor for new district:
• Date application submitted or anticipated: _ ----- --
• Proposed source(s)of supply for new district:
v. if a public water supply will not be used,describe plans to provide water supply for the project:
vi. If water supply will be from wells(public or private),what is the maximum pumping capacity: _gallons/minute.
d. Will the proposed action generate liquid wastes? ❑YesmNo
If Yes:
i. Total anticipated liquid waste generation per day: gallons/day
ii. Nature of liquid wastes to be generated(e.g.,sanitary wastewater,industrial, if combination,describe all components and
approximate volumes or proportions of each):
iii. Will the proposed action use any existing public wastewater treatment facilities? ❑Yes No
if Yes:
• Name of wastewater treatment plant to be used: --
• Name of district: --
• Does the existing wastewater treatment plant have capacity to serve the project? ❑Yes❑No
• Is the project site in the existing district? ❑Yes❑No
• Is expansion of the district needed? ❑Yes❑No
Page 5 of 13
• Do existing sewer lines serve the project site? ❑YesErNo
• Will a line extension within an existing district be necessary to serve the project? ❑YesBNo
If Yes:
• Describe extensions or capacity expansions proposed to serve this project:
iv. Will a new wastewater(sewage)treatment district be formed to serve the project site? ❑Yes[rT' o
If Yes:
• Applicant/sponsor for new district:
• Date application submitted or anticipated: -
• What is the receiving water for the wastewater discharge? ---
v. if public facilities will not be used,describe plans to provide wastewater treatment for the project,including specifying prupuscd
receiving water(name and classification if surface discharge or describe subsurface disposal plans):
vi. Describe any plans or designs to capture,recycle or reuse liquid waste:
e. Will the proposed action disturb more than one acre and create stormwater runoff,either from new point ®Yes❑No
sources(i.e. ditches,pipes,swales,curbs,gutters or other concentrated flows of stormwater)or non-point
source(i.e.sheet flow)during construction or post construction?
If Yes.
i. How much impervious surface will the project create in relation to total size of project parcel?
Square feet or 1.47 acres(impervious surface)
Square feet or 2.57 acres(parcel size)
ii. Describe types of new point sources. Landscape curbs buildings pavement&concrete
W. Where will the stormwater runoff be directed(i.e.on-site stormwater management facility/structures,adjacent properties,
groundwater,on-site surface water or off-site surface waters)?
On-site stormwater structures including drywells
• If to surface waters,identify receiving water bodies or wetlands:
W ill stormwater runoff flow to adjacent properties? ❑Yes®No
iv. Does the proposed plan minimize impervious surfaces,use pervious materials or collect and re-use stormwater? ®Yes❑No
f Does the proposed action include,or will it use on-site,one or more sources of air emissions, including fuel ❑Yes®No
combustion,waste incineration,or other processes or operations?
If Yes, identify:
i. Mobile sources during project operations(e.g.,heavy equipment,fleet or delivery vehicles)
ii. Stationary sources during construction(e.g.,power generation,structural heating,batch plant,crushers)
iii. Stationary sources during operations(e.g.,process emissions,large boilers,electric generation)
g. Will any air emission sources named in D?.f(above),require aNY State Air Registration,Air Facility Permit, ❑Yes®No
or Federal Clean Air Act Title IV or Title V Permit?
If Yes:
i. Is the project site located in an Air quality non-attainment area? (Area routinely or periodically fails to meet ❑Yes❑No
ambient air quality standards for a]I or some parts of the year)
ii. In addition to emissions as calculated in the application,the project will generate:
Tons/year(short tons)of Carbon Dioxide(CO,
• Tons/year(short tons)of Nitrous Oxide(N,O)
-Tons/year(short tons)of Perfluorocarbons(PFCs)
Tons/year(short tons)of Sulfur Hexafluoride(SF6)
Tons/year(short tons)of Carbon Dioxide equivalent of Hydroflourocarbons(HFCs)
Tons/year(short tons)of Hazardous Air Pollutants(HAPs)
Page 6 of 13
h. Will the proposed action generate or emit methane(including,but not limited to,sewage treatment plants, ❑Yes®No
landfills,composting facilities)?
If Yes:
i. Estimate methane generation in tons/year(metric):
U. Describe any methane capture,control or elimination measures included in project design(e.g.,combustion to generate heat or
electricity,flaring):
i. Will the proposed action result in the release of air pollutants from open-air operations or processes,such as ❑Yes®No
quarry or landfill operations?
If Yes: Describe operations and nature of emissions(e.g.,diesel exhaust,rock particulates/dust):
j.Will the proposed action result in a substantial increase in traffic above present levels or generate substantial ❑Yes®No
new demand for transportation facilities or services?
If Yes:
i. When is the peak traffic expected(Check all that apply): ❑Morning ❑ Evening []Weekend
❑ Randomly between hours of to
ii. For commercial activities only,projected number of trucktrips/day and type(e.g.,semi trailers and dump trucks):
iii. Parking spaces: Existing Proposed Net increase/decrease
iv. Does the proposed action include any shared use parking? ❑YesONo
v. If the proposed action includes any modification of existing roads,creation of new roads or change in existing access,describe:
vi. Are public/private transportation service(s)or facilities available within'/mile of the proposed site? ❑Yes[�JNo
vii Will the proposed action include access to public transportation or accommodations for use of hybrid,electric ❑YesONo
or other alternative fueled vehicles?
viii. Will the proposed action include plans for pedestrian or bicycle accorn modations for connections to existing ❑Yes❑No
pedestrian or bicycle routes?
k. Will the proposed action(for commercial or industrial projects only)generate new or additional demand ®Yes❑No
for energy?
If Yes:
i. Estimate annual electricity demand during operation of the proposed action: _-
22o mwh/year
ii. Anticipated sources/suppliers of electricity for the project(e.g.,on-site combustion,on-site renewable, via grid/local utility,or
other):
Local Utility
iii. Will the proposed action require a new,or an upgrade,to an existing substation? ❑Yes®No
I. Flours of operation. Answer all items which apply.
i. During Construction: ii. During Operations:
• Monday- Friday: 8 am to 5pm • Monday- Friday: __ 7 am to 6 pm
• Saturday: 8 am to 5 pm • Saturday: 7 am to 6 pm
• Sunday: -- -_-- - -- N/A Sunday: None
• Holidays: N/A Holidays:_ None
Page 7 of 13
m.Will the,proposed action produce noise that will exceed existing ambient noise levels during construction, ❑Yes®No
operation,or both?
If yes:
i. Provide details including sources,time of day and duration:
arriers that could act as a noise barrier or screen? El Yes No
ii. Will the proposed action remove existing natural b
Describe: -
n. Will the proposed action have outdoor lighting? ®Yes❑No
If ycs:
i. Describe source(s),location(s),height of fixture(s),direction/aim,and proximity to nearest occupied structures:
Buildin lights at 15'hi hand area li hts at 20'hi h
ii. Will proposed action remove existing natural barriers that could act as a light barrier or screen? ❑Yes®No
Describe: —
o. Does the proposed action have the potential to produce odors for more than one hour per day? ❑Yes®No
If Yes,describe possible sources,potential frequency and duration of odor emissions,and proximity to nearest
occupied structures: _- -- -- --- — - - --
P. Will the proposed action include any bulk storage of petroleum(combined capacity of over 1,100 gallons) ❑Yes®No
or chemical products 185 gallons in above ground storage or any amount in underground storage?
If Yes:
i. Product(s)to be stored —
ii. Volume(s)__ per unit time _ (e.g.,month,year) -- -
iii. Generally, describe the proposed storage facilities:
q.Will the proposed action(commercial, industrial and recreational projects only) use pesticides(i.e.,herbicides, ❑Yes ®No
insecticides)during construction or operation?
if Yes:
i. Describe proposed treatment(s):
ii. Will the proposed action use Integrated Pest Management Practices? ❑ Yes ®No
r. Will the proposed action(commercial or industrial projects only)involve or require the management or disposal JZ] Yes []No
of solid waste(excluding hazardous materials)?
If Yes:
i. Describe any solid waste(s)to be generated during construction or operation of the facility:
• Construction: 0.5 tons per month (unit of time)
• Operation : _ 2 tons per _ month (unit of time)
ii. Describe any proposals for on-site minimization,recycling or reuse of materials to avoid disposal as solid waste:
• Construction:
• Operation:
W. Proposed disposal methods/facilities for solid waste generated on-site:
• Construction:Private Carter to approved off-site solid waste disposal area in accordance with local.State and Federal requirements.
• Operation: Private Carter to approved oft-site solid waste disposal area in accordance with local,State,and Federal requirements.
Page 8 of 13
s. Does the proposed action include construction or modification of a solid waste management facility? ❑ Yes® No
If Yes:
i. Type of management or handling of waste proposed for the site(e.g.,recycling or transfer station,composting, landfill,or
other disposal activities):
ii. Anticipated rate of disposal/processing:
r Tons/month,if transfer or other non-combustion/thermal treatment,or
Tons/hour, if combustion or thermal treatment
iii. if landfill,anticipated site life: years
t. Will the proposed action at the site involve the commercial generation,treatment, storage,or disposal of hazardous❑Ycs®No
waste?
If Yes:
i. Name(s)of all hazardous wastes or constituents to be generated,handled or managed at facility:
ii. Generally describe processes or activities involving hazardous wastes or constituents:
iii. Specify amount to be handled or generated tons/month
iv. Describe any proposals for on-site minimization,recycling or reuse of hazardous constituents:
v. Will any hazardous wastes be disposed at an existing offsite hazardous waste facility? Yes No _
If Yes: provide name and location ol'facility:
If No: describe proposed management of any hazardous wastes which will not be sent to a hazardous waste facility:
E. Site and Setting of Proposed Action
E.I.Land uses on and surrounding the project site
a. Existing land uses.
i. Check all uses that occur on,adjoining and near the project site.
❑ Urban ❑ Industrial ® Commercial ® Residential(suburban) ❑ Rural (non-farm)
❑ Forest ❑ Agriculture ❑ Aquatic ❑ Other(specify):
ii. if mix of uses,generally describe:
b. Land uses and covertypes on the project site.
Land use or Current Acreage After Change
Covertype Acrea a Project Completion (Acres+/-)
• Roads,buildings,and other paved or impervious
1.47 +1.47
surfaces
• Forested 1.72 0.59 -1.13
• Meadows,grasslands or brushlands(non-
agricultural,including abandoned agricultural)
• Agricultural
(includes active orchards,field,greenhouse etc.)
• Surface water features
(lakes,ponds,streams,rivers,etc.)
• Wetlands(freshwater or tidal)
• Non-vegetated(bare rock,earth or fill)
• Other
Describe:Landscape 0.85 0.51 -0.34
Page 9 of 13
cJs the project site presently used by members of the community for public recreation? ❑Yes[Z]No
i. If Yes:explain:
d.Are there any facilities serving children,the elderly,people with disabilities(e.g.,schools,hospitals,licensed ❑YesmNo
day care centers,or group homes)within 1500 feet of the project site?
If Yes,
i. Identify Facilities:
e. Does the project site contain an existing dam? ❑YesmNo
If Yes:
i. Dimensions of the dam and impoundment:
• Dam height: _ _ _ - _. feet
• Dam length: -- _- _. feet
• Surface area: _ acres
• Volume impounded: _ _ _— gallons OR acre-feet
ii. Dam's existing hazard classification:
W. Provide date and summarize results of last inspection:
f. Has the project site ever been used as a municipal,commercial or industrial solid waste management facility. ❑YesJ4No
or does the project site adjoin property which is now,or was at one time,used as a solid waste management facility?
If Yes:
i. Has the facility been formally closed? ❑Yes❑ No
• i I'yes,cite sources/documentation: ----- -
ii. Describe the location of the project site relative to the boundaries of the solid waste management facility:
W. Describe any development constraints due to the prior solid waste activities:
g. Have hazardous wastes been generated,treated and/or disposed of at the site,or does the project site adjoin ❑YesmNo
properly which is now or was at one time used to commercially treat,store and/or dispose ofhazardous waste?
If Yes:
L Describe waste(s)handled and waste management activities,including approximate time when activities occurred:
h. Potential contamination history. Has there been a reported spill at the proposed project site,or have any ❑Yes® No
remedial actions been conducted at or adjacent to the proposed site?
If Yes:
i. Is any portion of the site listed on the NYSDEC Spills Incidents database or Environmental Site ❑Yes❑No
Remediation database? Check all that apply:
❑ Yes-Spills Incidents database Provide DEC ID number(s): _
❑ Yes-Environmental Site Remediation database Provide DEC ID number(s):
❑ Neither database
ii. If site has been subject of RCRA corrective activities,describe control measures:_________-_ ---
iii. Is the project within 2000 feet of any site in the NYSDEC Environmental Site Remediation database? ❑YesmNo
If yes,provide DEC ID number(s): -
il,. If yes to(i),(ii)or(iii)above,describe current status of site(s):
Page 10 of 13
v. Is the project site subject to an institutional control limiting property uses? ❑YesE]No
• if yes,DEC site 1D number:
• Describe the type of institutional control (e.g.,deed restriction or easement):
• Describe any use limitations:
• Describe any engineering controls:
• Will the project affect the institutional or engineering controls in place? Yes[_
• Explain:
E.2. Natural Resources On or Near Project Site
a. What is the average depth to bedrock on the project site? 1,000 feet
b.Are there bedrock outcroppings on the project site? ❑Yes®No
If Yes,what proportion of the site is comprised of bedrock outcroppings? _ %
c. Predominant soil type(s)present on project site: Riverhead Sandy Loam 100 %
d.What is the average depth to the water table on the project site? Average: 38 feet
e. Drainage status of project site soils:® Well Drained: 100%of site
❑ Moderately Well Drained: %of site
❑ Poorly Drained %of site
f. Approximate proportion of proposed action site with slopes: ® 0-10%: 10_0%of site
❑ 10-15%: %of site
❑ 15%or greater: _%of site
g.Are there any unique geologic feahnes on the project site? ❑YesmNo
If Yes,describe:
h. Surface water features.
i. Does any portion of the project site contain wetlands or other waterbodies(including streams,rivers, ❑YesmNo
ponds or lakes)?
ii. Do any wetlands or other waterbodies adjoin the project site? ❑YesmNo
If Yes to either i or ii,continue. If No, skip to E.2.i.
iii. Are any of the wetlands or waterbodies within or adjoining the project site regulated by any federal, ❑YesmNo
state or local agency?
iv. For each identified regulated wetland and waterbody on the project site,provide the following information:
• Streams: Name _ Classification
• Lakes or Ponds: Name Classification _
• Wetlands: Name Approximate Size
• Wetland No.(if regulated by DEC)
v. Are any of the above water bodies listed in the most recent compilation ofNYS water quality-impaired ❑YesmNo
waterbodies?
If yes,name of impaired water body/bodies and basis for listing as impaired:
i. is the project site in a designated Floodway? ❑YesmNo
j. Is the project site in the 100-year Floodplain? ❑YesmNo
k. Is the project site in the 500-year Floodplain? ❑YesmNo
1. Is the project site located over,or immediately adjoining,a primary,principal or sole source aquifer? mYes❑No
If Yes:
i. Name of aquifer:Sole Source Aquifer Names:Nassau-Suffolk SSA
Page II ofl3
m. Identify the predominant wildlife species that occupy or use the project site:
small mammals --
song birds_
n. Does the project site contain a designated significant natural community? ❑YesmNo
If Yes:
i. Describe the habitat/community(composition, function,and basis for designation):
ii. Source(s)of description or evaluation:
W. Extent of community/habitat:
• Currently: acres
• Following completion of project as proposed: _ _ acres
• Gain or loss(indicate+or-): _ acres
o. Does project site contain any species of plant or animal that is listed by the federal government or NYS as m Yes❑No
endangered or threatened,or does it contain any areas identified as habitat for an endangered or threatened species?
I I'Yes:
i. Species and listing(endangered or threatened):
Northern Long-eared Bat
p. Does the project site contain any species of plant or animal that is listed by NYS as rare, or as a species of YesmNo
special concern?
if Yes:
i. Species and listing:
q. is the project site or adjoining area currently used for hunting,trapping,fishing or shell fishing? ❑YesmNo
If yes,give a brief description of how the proposed action may affect that use:
E.3. Designated Public Resources On or Near Project Site
a. is the project site,or any portion of it, located in a designated agricultural district certified pursuant to ❑YesmNo
Agriculture and Markets Law,Article 25-AA,Section 303 and 304?
If Yes, provide county plus district name/number:
b. Are agricultural lands consisting of highly productive soils present? ❑YesmNo
i. if Yes: acreage(s)on project site?
H. Source(s)of soil rating
(s):
c. Does the project site contain all or part of,or is it substantially contiguous to,a registered National ❑YesmNo
Natural Landmark?
If Yes:
i. Nature of the natural landmark: ❑ Biological Community ❑ Geological Feature
ii. Provide brief description of landmark, including values behind designation and approximate size/extent:
d. is the project site located in or does it adjoin a state listed Critical Environmental Area? mYes❑No
If Yes:
i. CEA name: SGPA,Central Suffolk Pine Barrens
ii. Basis for designation: Protect groundwater,Benefit to human health&protect drinking water
iii. Designating agency and date: Agency-Long Island Regional Planning,Agency:Suffolk County,Date:3-19-93,Date:2-10-88
Page 12 of 13
e.Does the project site contain,or is it substantially contiguous to,a building,archaeological site,or district ❑Yes®No
which is listed on the National or State Register of Historic Places,or that has been determined by the Commissioner of the NYS
Office of Parks,Recreation and Historic Preservation to be eligible for listing on the State Register of Historic Places'?
If Yes:
•i.Nature.of historic/archaeological resource: ❑Archaeological Site ❑Historic Building or District
ii.Name: _ _
iii. Brief description of attributes on which listing is based
f.Is the project site,or any portion of it, located in or adjacent to an area designated as sensitive for ®Yes❑No
archaeological sites on the NY State Historic Preservation Office(SHPO)archaeological site inventory'?
g.Have additional archaeological or historic site(s)or resources been identified on the project site? ❑Yesg]No
if Yes:
i. Describe possible resource(s):
ii. Basis for identification:
h. Is the project site within fives miles of any officially designated and publicly accessible federal, state,or local ❑Yes®No
scenic or aesthetic resource'?
If Yes:
i. Identify resource: _
ii.Nature of,or basis for,designation(e.g., established highway overtook.state or local park,state historic trail or scenic byway,
etc.): - -- -- —
iii. Distance between project and resource: miles.
i. Is the project site located within a designated river corridor under the Wild. Scenic and Recreational Rivers ❑Yes❑No
Program 6 NYCRR 666"
If Yes:
i. Identify the name oFthe river and its designation:
ii. I, the activity consistent with development restrictions contained in 6NYCRR Part 666? ❑Yes❑No
r,Additional Information
Attach any additional information which may be needed to clarity your project.
If you have identified any adverse impacts which could be associated with your proposal,please describe those impacts Plus any
measures which you propose to avoid or minimize them.
G. Verification
i certify that the information provided is true to the best of my knowledge.
Applicant/Sponsor Name MArc Pilolta.P.E. _ Date 01/10/2025
Signature Title Project Engineer
PRINT FORM Page 13 of 13
EAF-Mapper Summary Report Thursday, January 9, 2025 9:17 AM
Disclaimer: The EAF Mapper is a screening tool intended to assist
project sponsors and reviewing agencies in preparing an environmental
!'I assessment form(EAF).Not all questions asked in the EAF are
answered by the EAF Mapper.Additional Information on any EAF
I'i t 4-7 question can be obtained by consulting the EAF Workbooks. Although
the EAF Mapper provides the most up-to-date digital data available to
1'I"+ -1 -i I DEC,you may also need to contact local or other data sources In order
to obtain data not provided by the Mapper.Digital data is not a
substitute for agency determinations.
4
. 1'1.' 'IY•cI E�.r M:uu;;I;.,. rLrolp�r
1 t"_-1 \� Sou tool d =,:r❑ntc;` t
i l '• -12-1 ' r I I_wnhou
t-1 _2-fit
E" .1E-E ��m-) • ' rur_r
I A rl :,; .I J _
B.i.i [Coastal or Waterfront Area] Yes
B"i"ii [Local Waterfront Revitalization Area] Yes
C.2.b. [Special Planning District] Yes-Digital mapping data are not available for all Special Planning Districts.
Refer to EAF Workbook.
C.2.b. [Special Planning District- Name] NYS Heritage Areas:Ll North Shore Heritage Area
E.1.h [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Potential Contamination History] Workbook.
E.1.h.i [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Listed] Workbook.
E.1.h.i [DEC Spills or Remediation Site - Digital mapping data are not available or are incomplete. Refer to EAF
Environmental Site Remediation Database] Workbook.
E.1.h.iii [Within 2,000' of DEC Remediation No
Site]
E.2.g [Unique Geologic Features] No
E.2.h.i [Surface Water Features] No
E.2.h.ii [Surface Water Features] No
E.2.h.iii [Surface Water Features] No
E.2.h.v [Impaired Water Bodies] No
E.2.i. [Floodway] No
E.2.j. [100 Year Floodplain] No
E.2.k. [500 Year Floodplain] No
E.2.1. [Aquifers] Yes
E.2.1. [Aquifer Names] Sole Source Aquifer Names:Nassau-Suffolk SSA
E.2.n. [Natural Communities] No
E.2.o. [Endangered or Threatened Species] Yes
Full Environmental Assessment Form - EAF Mapper Summary Report f
Name]
E.2.p. [Rare Plants or Animals] No
E.3.a. [Agricultural District] ;No
E.3.c. [National Natural Landmark] No
E.3.d [Critical Environmental Area] .'Yes
E.3.d [Critical Environmental Area- Name] SGPA, Central Suffolk Pine Barrens
E.3.d.ii [Critical Environmental Area- Protect groundwater, Benefit to human health & protect drinking water
Reason]
E.3.d.iii [Critical Environmental Area— Date Agency:Long Island Regional Planning, Agency:Suffolk County, Date:3-19-93,
and Agency] Date:2-10-88
E.3.e. [National or State Register of Historic ;Digital mapping data are not available or are incomplete. Refer to EAF
Places or State Eligible Sites] Workbook.
E.3.f. [Archeological Sites] Yes
E.3.i. [Designated River Corridor] No
Full Environmental Assessment Form - EAF Mapper Summary Report 2